Provider Demographics
NPI:1427501725
Name:SWORE, KATHRYN DEENA (DPT)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:DEENA
Last Name:SWORE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3190 E MERIDIAN PARK LOOP STE 206A
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7422
Mailing Address - Country:US
Mailing Address - Phone:907-373-9462
Mailing Address - Fax:907-373-9464
Practice Address - Street 1:3190 E MERIDIAN PARK LOOP STE 206A
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7422
Practice Address - Country:US
Practice Address - Phone:907-373-9462
Practice Address - Fax:907-373-9464
Is Sole Proprietor?:No
Enumeration Date:2016-08-03
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK155876225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant